If participants in North Carolina political debate truly wish to serve the public, they will say what they mean and mean what they say.

For example, politicians and activists on the Left, and more than a few on the Right, say that people need health insurance because without it, they can’t afford routine medical services. This is an incoherent statement. If North Carolinians can’t afford routine health care, creating an insurance program won’t help them.

All insurance is financial insurance. It is a means of managing the financial risk of a sudden, unwelcome and disastrous event. If everyone reasonably expected to make more annual monetary claims on their insurance than they pay in annual premiums, the insurance would never be offered because the insurance pool would be unsustainable. There would never be enough money available to pay all the claims.

To use medical insurance as a mechanism to finance annual physicals and occasional doctor visits for minor injuries or infections makes no more sense than using auto insurance to finance oil and tire changes or homeowners insurance to finance house painting or air-conditioner service.

{mosimage}It’s not that these aren’t worthwhile, even necessary, expenditures. You ought to change your oil and tires. You ought to keep your home and its major systems in good repair. But because these are routine expenses, creating an insurance pool and having everyone send money in and make claims out would be a silly way to pay the bills. You might achieve some bulk-buying advantages, but they’d be offset by the administrative and billing costs.

If made “universal” by government mandate, such an insurance system would penalize car and home owners with relatively new property requiring less attention, sufficient savings to cover their needs or the requisite skills to fix their own cars and homes. They would have to pay money in knowing that they will be net losers. If the system isn’t mandatory, many of these folks would see no rational reason to participate and would forgo the insurance, leaving the system with more claims than revenue and necessitating higher premiums, which would chase still more customers away. A vicious cycle would ensue.

Sound familiar?

When political activists say they want to “insure” everyone, what they really mean is that they want to socialize the payment of doctors, hospitals and other medical providers. That is, they want to use government’s taxing and regulatory powers to force healthier and wealthier people to pay the cost of treating sicker and poorer people. They want to redistribute income, in other words.

Sure, they often argue that expanding insurance coverage of preventive services in the short run will save taxpayers money in the long run, but the argument is invalid. While some forms of preventive care reduce overall health-care costs by heading off diseases or complications, most preventive care doesn’t. Governing magazine recently observed that the “growing consensus in the medical research community is that preventive care usually does not save money.”

So don’t be distracted by those who claim that “insuring” more people will save money by increasing the use of preventive care. The game here is income redistribution.

Needless to say, I’m not a fan of socialism. It is grotesque and impractical. Human beings do have a moral responsibility to help those less fortunate, starting with their own family and neighbors and then extending beyond that to the human race as a whole. But this is a moral responsibility free individuals must choose to shoulder, not a justification for state-assisted theft (hey, Lefties, what happened to the idea that the government shouldn’t legislate morality?)

However, at least if advocates of government health care said what they really meant, rather than hiding behind insurance terminology that doesn’t fit, we could have an honest discussion about freedom, socialism and the proper use of force in addressing social problems. Because North Carolinians and other Americans still don’t cotton to straightforward calls for socialism or even European-style social democracy, its pallid cousin, you shouldn’t count on these advocates to say what they mean.